fundamentals of nursing viii

8/9/2019 Fundamentals of Nursing VIII

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PRACTICE TEST QUESTIONS

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Infection, Asepsis, Basic concept of stress and Illness

FUNDAMENTALS OF NURSING TEST II

CONTENT OUTLINE

1. Illness

2. Infection and Asepsis

3. Basic concept of Stress and Adaptation

1. When the General adaptation syndrome is activated, FLIGHT OR FIGHT response setsin. Sympathetic nervous system releases norepinephrine while the adrenal medullasecretes epinephrine. Which of the following is true with regards to that statement?

A. Pupils will constrictB. Client will be lethargicC. Lungs will bronchodilate

D. Gastric motility will increase

* To better understand the concept : The autonomic nervous system is composed ofSYMPATHETIC and PARASYMPATHETIC Nervous system. It is called AUTONOMICBecause it is Involuntary and stimuli based. You cannot tell your heart to kindly beat for60 per minute, Nor, Tell your blood vessels, Please constrict, because you need to wear

skirt today and your varicosities are bulging. Sympathetic Nervous system is the FIGHTor FLIGHT mechanism. When people FIGHT or RUN, we tend to stimulate the ANS anddominate over SNS. Just Imagine a person FIGHTING and RUNNING to get the idea onthe signs of SNS Domination. Imagine a resting and digesting person to get a picture ofPNS Domination. A person RUNNING or FIGHTING Needs to bronchodilate, because the

oxygen need is increased due to higher demand of the body. Pupils will DILATE to beable to see the enemy clearly. Client will be fully alert to dodge attacks and leap throughobstacles during running. The client's gastric motility will DECREASE Because you cannotafford to urinate or defecate during fighting nor running.

2. Which of the following response is not expected to a person whose GAS is activatedand the FIGHT OR FLIGHT response sets in?

A. The client will not urinate due to relaxation of the detrusor muscleB. The client will be restless and alert


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C. Clients BP will increase, there will be vasodilation

D. There will be increase glycogenolysis, Pancrease will decrease insulin secretion

* If vasodilation will occur, The BP will not increase but decrease. It is true that Bloodpressure increases during SNS Stimulation due to the fact that we need more BLOOD tocirculate during the FIGHT or FLIGHT Response because the oxygen demand hasincreased, but this is facilitated by vasoconstriction and not vasodilation. A,B and D areall correct. The liver will increase glycogenolysis or glycogen store utilization due to aheightened demand for energy. Pancrease will decrease insulin secretion because almostevery aspect of digestion that is controlled by Parasympathetic nervous system isinhibited when the SNS dominates.

3. State in which a persons physical, emotional, intellectual and social development orspiritual functioning is diminished or impaired compared with a previous experience.

A. Illness

B. DiseaseC. Health

D. Wellness

* Disease is a PROVEN FACT based on a medical theory, standards, diagnosis andclinical feature while ILLNESS Is a subjective state of not feeling well based onsubjective appraisal, previous experience, peer advice etc.

4. This is the first stage of illness wherein, the person starts to believe that something iswrong. Also known as the transition phase from wellness to illness.

A. Symptom Experience

B. Assumption of sick roleC. Medical care contactD. Dependent patient role

* A favorite board question are Stages of Illness. When a person starts to believesomething is wrong, that person is experiencing signs and symptoms of an illness. Thepatient will then ASSUME that he is sick. This is called assumption of the sick role wherethe patient accepts he is Ill and try to give up some activities. Since the client onlyASSUMES his illness, he will try to ask someone to validate if what he is experiencing is

a disease, This is now called as MEDICAL CARE CONTACT. The client seeks professionaladvice for validation, reassurance, clarification and explanation of the symptoms he isexperiencing. client will then start his dependent patient role of receiving care from thehealth care providers. The last stage of Illness is the RECOVERY stage where the patientgives up the sick role and assumes the previous normal gunctions.

5. In this stage of illness, the person accepts or rejects a professionals suggestion. Theperson also becomes passive and may regress to an earlier stage.



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B. Assumption of sick role

C. Medical care contactD. Dependent patient role

* In the dependent patient role stage, Client needs professionals for help. They have achoice either to accept or reject the professional's decisions but patients are usuallypassive and accepting. Regression tends to occur more in this period.

6. In this stage of illness, The person learns to accept the illness.


B. Assumption of sick roleC. Medical care contactD. Dependent patient role

* Acceptance of illness occurs in the Assumption of sick role phase of illness.

7. In this stage, the person tries to find answers for his illness. He wants his illness to be

validated, his symptoms explained and the outcome reassured or predicted

A. Symptom ExperienceB. Assumption of sick roleC. Medical care contactD. Dependent patient role

* At this stage, The patient seeks for validation of his symptom experience. He wants tofind out if what he feels are normal or not normal. He wants someone to explain why ishe feeling these signs and symptoms and wants to know the probable outcome of this

experience.

8. The following are true with regards to aspect of the sick role except

A. One should be held responsible for his conditionB. One is excused from his societal roleC. One is obliged to get well as soon as possibleD. One is obliged to seek competent help

* The nurse should not judge the patient and not view the patient as the cause orsomeone responsible for his illness. A sick client is excused from his societal roles,Oblige to get well as soon as possible and Obliged to seek competent help.

9. Refers to conditions that increases vulnerability of individual or group to illness oraccident

A. Predisposing factorB. EtiologyC. Risk factor


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D. Modifiable Risks

10. Refers to the degree of resistance the potential host has against a certain pathogen

A. SusceptibilityB. ImmunityC. VirulenceD. Etiology

* Immunity is the ABSOLUTE Resistance to a pathogen considering that person has anINTACT IMMUNITY while susceptibility is the DEGREE of resistance. Degree of resistance

means how well would the individual combat the pathogens and repel infection orinvasion of these disease causing organisms. A susceptible person is someone who has avery low degree of resistance to combat pathogens. An Immune person is someone thatcan easily repel specific pathogens. However, Remember that even if a person isIMMUNE [ Vaccination ] Immunity can always be impaired in cases of chemotherapy,

HIV, Burns, etc.

11. A group of symptoms that sums up or constitute a disease

A. SyndromeB. SymptomsC. SignsD. Etiology

* Symptoms are individual manifestation of a certain disease. For example, In Tourettesyndrome, patient will manifest TICS, but this alone is not enough to diagnose thepatient as other diseases has the same tic manifestation. Syndrome means COLLECTION

of these symptoms that occurs together to characterize a certain disease. Tics withcoprolalia, echolalia, palilalia, choreas or other movement disorders are characteristics ofTOURETTE SYNDROME.

12. A woman undergoing radiation therapy developed redness and burning of the skinaround the best. This is best classified as what type of disease?

A. NeoplasticB. Traumatic

C. NosocomialD. Iatrogenic

* Iatrogenic diseases refers to those that resulted from treatment of a certain disease.For example, A child frequently exposed to the X-RAY Machine develops redness andpartial thickness burns over the chest area. Neoplastic are malignant diseases cause byproliferation of abnormally growing cells. Traumatic are brought about by injuries likeMotor vehicular accidents. Nosocomial are infections that acquired INSIDE the hospital.Example is UTI Because of catheterization, This is commonly caused by E.Coli.


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13. The classification of CANCER according to its etiology Is best described as

1. Nosocomial2. Idiopathic3. Neoplastic4. Traumatic5. Congenital6. Degenrative

A. 5 and 2B. 2 and 3

C. 3 and 4D. 3 and 5

* Aside from being NEOPLASTIC, Cancer is considered as IDIOPATHIC because thecause is UNKNOWN.

14. Term to describe the reactiviation and recurrence of pronounced symptoms of a

disease

A. RemissionB. EmissionC. ExacerbationD. Sub acute

15. A type of illness characterized by periods of remission and exacerbation

A. Chronic

B. AcuteC. Sub acuteD. Sub chronic

* A good example is Multiple sclerosis that characterized by periods of remissions andexacerbation and it is a CHRONIC Disease. An acute and sub acute diseases occurs tooshort to manifest remissions. Chronic diseases persists longer than 6 months that is whyremissions and exacerbation are observable.

16. Diseases that results from changes in the normal structure, from recognizableanatomical changes in an organ or body tissue is termed as

A. FunctionalB. OccupationalC. InorganicD. Organic

* As the word implies, ORGANIC Diseases are those that causes a CHANGE in thestructure of the organs and systems. Inorganic diseases is synonymous with


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FUNCTIONAL diseases wherein, There is no evident structural, anatomical or physical

change in the structure of the organ or system but function is altered due to othercauses, which is usually due to abnormal response of the organ to stressors. Therefore,ORGANIC BRAIN SYNDROME are anatomic and physiologic change in the BRAIN that isNON PROGRESSIVE BUT IRREVERSIBLE caused by alteration in structure of the brainand it's supporting structure which manifests different sign and symptoms ofneurological, physiologic and psychologic alterations. Mental disorders manifestingsymptoms of psychoses without any evident organic or structural damage are termed asINORGANIC PSYCHOSES while alteration in the organ structures that causes symptomsof bizaare pyschotic behavior is termed as ORGANIC PSYCHOSES.

17. It is the science of organism as affected by factors in their environment. It dealswith the relationship between disease and geographical environment.

A. EpidemiologyB. Ecology

C. StatisticsD. Geography

* Ecology is the science that deals with the ECOSYSTEM and its effects on living thingsin the biosphere. It deals with diseases in relationship with the environment.Epidimiology is simply the Study of diseases and its occurence and distribution in manfor the purpose of controlling and preventing diseases. This was asked during theprevious boards.

18. This is the study of the patterns of health and disease. Its occurrence anddistribution in man, for the purpose of control and prevention of disease.

A. EpidemiologyB. EcologyC. Statistics

D. Geography

* Refer to number 17.

19. Refers to diseases that produced no anatomic changes but as a result from abnormalresponse to a stimuli.

A. FunctionalB. OccupationalC. InorganicD. Organic

* Refer to number 16.

20. In what level of prevention according to Leavell and Clark does the nurse supportthe client in obtaining OPTIMAL HEALTH STATUS after a disease or injury?


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A. PrimaryB. SecondaryC. TertiaryD. None of the above

* Perhaps one of the easiest concept but asked frequently in the NLE. Primary refers topreventions that aims in preventing the disease. Examples are healthy lifestyle, goodnutrition, knowledge seeking behaviors etc. Secondary prevention are those that dealswith early diagnostics, case finding and treatments. Examples are monthly breast selfexam, Chest X-RAY, Antibiotic treatment to cure infection, Iron therapy to treat anemia

etc. Tertiary prevention aims on maintaining optimum level of functioning during or afterthe impact of a disease that threatens to alter the normal body functioning. Examplesare prosthetis fitting for an amputated leg after an accident, Self monitoring of glucoseamong diabetics, TPA Therapy after stroke etc.

The confusing part is between the treatment in secondary and treatment in tertiary. Tobest differentiate the two, A client with ANEMIA that is being treated with ferrous sulfate

is considered being in the SECONDARY PREVENTION because ANEMIA once treated, willmove the client on PRE ILLNESS STATE again. However, In cases of ASPIRING Therapyin cases of stroke, ASPIRING no longer cure the patient or PUT HIM IN THE PRE ILLNESSSTATE. ASA therapy is done in order to prevent coagulation of the blood that can lead tothrombus formation and a another possible stroke. You might wonder why I spelledASPIRIN as ASPIRING, Its side effect is OTOTOXICITY [ CN VIII ] that leads to TINNITUSor ringing of the ears.

21. In what level of prevention does the nurse encourage optimal health and increasespersons susceptibility to illness?

A. PrimaryB. Secondary

C. TertiaryD. None of the above

* The nurse never increases the person's susceptibility to illness but rather, LESSEN theperson's susceptibility to illness.

22. Also known as HEALTH MAINTENANCE prevention.


* Secondary prevention is also known as HEALTH MAINTENANCE Prevention. Here, Theperson feels signs and symptoms and seeks Diagnosis and treatment in order to preventdeblitating complications. Even if the person feels healthy, We are required to MAINTAIN


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our health by monthly check ups, Physical examinations, Diagnostics etc.

23. PPD In occupational health nursing is what type of prevention?


* PPD or PERSONAL PROTECTIVE DEVICES are worn by the workes in a hazardousenvironment to protect them from injuries and hazards. This is considered as a PRIMARY

prevention because the nurse prevents occurence of diseases and injuries.

24. BCG in community health nursing is what type of prevention?

A. Primary

B. SecondaryC. Tertiary

D. None of the above

25. A regular pap smear for woman every 3 years after establishing normal pap smearfor 3 consecutive years Is advocated. What level of prevention does this belongs?


26. Self monitoring of blood glucose for diabetic clients is on what level of prevention?

A. Primary

B. SecondaryC. TertiaryD. None of the above

27. Which is the best way to disseminate information to the public?

A. NewspaperB. School bulletinsC. Community bill boardsD. Radio and Television

* An actual board question, The best way to disseminate information to the public is byTELEVISION followed by RADIO. This is how the DOH establish its IEC Programs otherthan publising posters, leaflets and brochures. An emerging new way to disseminate isthrough the internet.


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28. Who conceptualized health as integration of parts and subparts of an individual?

A. NewmanB. NeumanC. WatsonD. Rogers

* The supra and subsystems are theories of Martha Rogers but the parts and subpartsare Betty Neuman's. She stated that HEALTH is a state where in all parts and subpartsof an individual are in harmony with the whole system. Margarex Newman definedhealth as an EXPANDING CONSCIOUSNESS. Her name is Margaret not Margarex, I just

used that to help you remember her theory of health.

29. The following are concept of health:

1. Health is a state of complete physical, mental and social wellbeing and not merely an

absence of disease or infirmity.2. Health is the ability to maintain balance

3. Health is the ability to maintain internal milieu4. Health is integration of all parts and subparts of an individual

A. 1,2,3B. 1,3,4C. 2,3,4D. 1,2,3,4

* All of the following are correct statement about health. The first one is the definitionby WHO, The second one is from Walter Cannon's homeostasis theory. Third one is from

Claude Bernard's concept of Health as Internal Milieu and the last one is Neuman'sTheory.

30. The theorist the advocated that health is the ability to maintain dynamic equilibriumis

A. BernardB. SelyeC. Cannon

D. Rogers

* Walter Cannon advocated health as HOMEOSTASIS or the ability to maintain dynamicequilibrium. Hans Selye postulated Concepts about Stress and Adaptation. Bernarddefined health as the ability to maintain internal milieu and Rogers defined Health asWellness that is influenced by individual's culture.

31. Excessive alcohol intake is what type of risk factor?

A. Genetics


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B. Age

C. EnvironmentD. Lifestyle

32. Osteoporosis and degenerative diseases like Osteoarthritis belongs to what type ofrisk factor?

A. GeneticsB. AgeC. EnvironmentD. Lifestyle

33. Also known as STERILE TECHNIQUE

A. Surgical AsepsisB. Medical Asepsis

C. SepsisD. Asepsis

* Surgical Asepsis is also known as STERILE TECHNIQUE while Medical Asepsis issynonymous with CLEAN TECHNIQUE.

34. This is a person or animal, who is without signs of illness but harbors pathogenwithin his body and can be transferred to another

A. HostB. AgentC. Environment

D. Carrier

35. Refers to a person or animal, known or believed to have been exposed to a disease.

A. CarrierB. ContactC. AgentD. Host

36. A substance usually intended for use on inanimate objects, that destroys pathogensbut not the spores.

A. SterilizationB. DisinfectantC. AntisepticD. Autoclave

* Disinfectants are used on inanimate objects while Antiseptics are intended for use onpersons and other living things. Both can kill and inhibit growth of microorganism but


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cannot kill their spores. That is when autoclaving or steam under pressure gets in,

Autoclaving can kill almost ALL type of microoganism including their spores.

37. This is a process of removing pathogens but not their spores

A. SterilizationB. Auto clavingC. DisinfectionD. Medical asepsis

* Both A and B are capable on killing spores. Autoclaving is a form of Sterilization.

Medical Asepsis is a PRACTICE designed to minimize or reduce the transfer ofpathogens, also known as your CLEAN TECHNIQUE. Disinfection is the PROCESS ofremoving pathogens but not their spores.

38. The third period of infectious processes characterized by development of specific

signs and symptoms

A. Incubation periodB. Prodromal periodC. Illness periodD. Convalescent period

* In incubation period, The disease has been introduced to the body but no sign andsymptom appear because the pathogen is not yet strong enough to cause it and maystill need to multiply. The second period is called prodromal period. This is when theappearance of non specific signs and symptoms sets in, This is when the sign andsymptoms starts to appear. Illness period is characterized by the appearance of specific

signs and symptoms or refer tp as time with the greatest symptom experience. Acme isthe PEAK of illness intensity while the convalescent period is characterized by theabatement of the disease process or it's gradual disappearance.

39. A child with measles developed fever and general weakness after being exposed toanother child with rubella. In what stage of infectious process does this child belongs?

A. Incubation periodB. Prodromal period

C. Illness periodD. Convalescent period

* To be able to categorize MEASLES in the Illness period, the specific signs of Fever,Koplik's Spot and Rashes must appear. In the situation above, Only general signs andsymptoms appeared and the Specific signs and symptoms is yet to appear, therefore,the illness is still in the Prodromal period. Signs and symptoms of measles during theprodromal phase are Fever, fatigue, runny nose, cough and conjunctivitis. Koplik's spotheralds the Illness period and cough is the last symptom to disappear. All of thisprocesses take place in 10 days that is why, Measles is also known as 10 day measles.


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40. A 50 year old mailman carried a mail with anthrax powder in it. A minute afterexposure, he still hasnt developed any signs and symptoms of anthrax. In what stage ofinfectious process does this man belongs?

A. Incubation periodB. Prodromal periodC. Illness periodD. Convalescent period

* Anthrax can have an incubation period of hours to 7 days with an average of 48 hours.

Since the question stated exposure, we can now assume that the mailman is in theincubation period.

41. Considered as the WEAKEST LINK in the chain of infection that nurses canmanipulate to prevent spread of infection and diseases

A. Etiologic/Infectious agent

B. Portal of EntryC. Susceptible hostD. Mode of transmission

* Mode of transmission is the weakest link in the chain of infection. It is easilymanipulated by the Nurses using the tiers of prevention, either by institutingtransmission based precautions, Universal precaution or Isolation techniques.

42. Which of the following is the exact order of the infection chain?

1. Susceptible host2. Portal of entry3. Portal of exit

4. Etiologic agent5. Reservoir6. Mode of transmission

A. 1,2,3,4,5,6B. 5,4,2,3,6,1

C. 4,5,3,6,2,1D. 6,5,4,3,2,1

* Chain of infection starts with the SOURCE : The etiologic agent itself. It will firstproliferate on a RESERVOIR and will need a PORTAL OF EXIT to be able to TRANSMITirslef using a PORTAL OF ENTRY to a SUSCEPTIBLE HOST. A simple way to understandthe process is by looking at the lives of a young queen ant that is starting to build hercolony. Imagine the QUEEN ANT as a SOURCE or the ETIOLOGIC AGENT. She first needto build a COLONY, OR the RESERVOIR where she will start to lay the first eggs to beable to produce her worker ants and soldier ants to be able to defend and sustain the


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new colony. They need to EXIT [PORTAL OF EXIT] their colony and crawl [MODE OF

TRANSMISSION] in search of foods by ENTERING / INVADING [PORTAL OF ENTRY] ourHOUSE [SUSCEPTIBLE HOST]. By imagining the Ant's life cycle, we can easily arrangethe chain of infection.

43. Markee, A 15 year old high school student asked you. What is the mode oftransmission of Lyme disease. You correctly answered him that Lyme disease istransmitted via

A. Direct contact transmissionB. Vehicle borne transmission

C. Air borne transmissionD. Vector borne transmission

* Lyme disease is caused by Borrelia Burdorferi and is transmitted by a TICK BITE.

44. The ability of the infectious agent to cause a disease primarily depends on all of thefollowing except

A. PathogenicityB. VirulenceC. InvasivenessD. Non Specificity

* To be able to cause a disease, A pathogen should have a TARGET ORGAN/S. Thepathogen should be specific to these organs to cause an infection. Mycobacterium Aviumis NON SPECIFIC to human organs and therefore, not infective to humans but deadly tobirds. An immunocompromised individual, specially AIDS Patient, could be infected with

these NON SPECIFIC diseases due to impaired immune system.

45. Contact transmission of infectious organism in the hospital is usually cause by

A. Urinary catheterizationB. Spread from patient to patientC. Spread by cross contamination via hands of caregiverD. Cause by unclean instruments used by doctors and nurses

* The hands of the caregiver like nurses, is the main cause of cross contamination inhospital setting. That is why HANDWASHING is the single most important procedure toprevent the occurence of cross contamination and nosocomial infection. D refers toNosocomial infection and UTI is the most common noscomial infection in the hospitalcaused by urinary catheterization. E.Coli seems to be the major cause of this incident. Bbest fits Cross Contamination, It is the spread of microogranisms from patient o patient.

46. Transmission occurs when an infected person sneezes, coughs or laugh that isusually projected at a distance of 3 feet.


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A. Droplet transmission

B. Airborne transmissionC. Vehicle transmissionD. Vector borne transmission

47. Considered as the first line of defense of the body against infection

A. SkinB. WBCC. LeukocytesD. Immunization

* Remember that intact skin and mucus membrane is our first line of defense againstinfection.

48. All of the following contributes to host susceptibility except

A. Creed

B. ImmunizationC. Current medication being takenD. Color of the skin

* Creed, Faith or religious belief do not affect person's susceptibility to illness.Medication like corticosteroids could supress a person's immune system that will lead toincrease susceptibility. Color of the skin could affect person's susceptibility to certainskin diseases. A dark skinned person has lower risk of skin cancer than a fair skinnedperson. Fair skinned person also has a higher risk for cholecystitis and cholelithiasis.

49. Graciel has been injected TT5, her last dosed for tetanus toxoid immunization.Graciel asked you, what type of immunity is TT Injections? You correctly answer her bysaying Tetanus toxoid immunization is a/an

A. Natural active immunityB. Natural passive immunityC. Artificial active immunityD. Artificial passive immunity

* TT1 ti TT2 are considered the primary dose, while TT3 to TT5 are the booster dose. Awoman with completed immunization of DPT need not receive TT1 and TT2. Tetanustoxoid is the actual toxin produce by clostridium tetani but on its WEAK andINACTIVATED form. It is Artificial because it did not occur in the course of actual illnessor infection, it is Active because what has been passed is an actual toxin and not a readymade immunoglobulin.

50. Agatha, was hacked and slashed by a psychotic man while she was crossing therailway. She suffered multiple injuries and was injected Tetanus toxoid Immunoglobulin.Agatha asked you, What immunity does TTIg provides? You best answered her by saying


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TTIg provides

A. Natural active immunityB. Natural passive immunityC. Artificial active immunityD. Artificial passive immunity

* In this scenario, Agatha was already wounded and has injuries. Giving the toxin [TTVaccine] itself would not help Agatha because it will take time before the immunesystem produce antitoxin. What agatha needs now is a ready made anti toxin in theform of ATS or TTIg. This is artificial, because the body of agatha did not produce it. It is

passive because her immune system is not stimulated but rather, a ready made Immuneglobulin is given to immediately supress the invasion.

51. This is the single most important procedure that prevents cross contamination andinfection

A. Cleaning

B. DisinfectingC. SterilizingD. Handwashing

* When you see the word HANDWASHING as one of the options, 90% Chance it is thecorrect answer in the local board. Or should I say, 100% because I have yet to seequestion from 1988 to 2005 board questions that has option HANDWASHING on it but isnot the correct answer.

52. This is considered as the most important aspect of handwashing

A. TimeB. Friction

C. WaterD. Soap

* The most important aspect of handwashing is FRICTION. The rest, will just enhancefriction. The use of soap lowers the surface tension thereby increasing the effectivenessof friction. Water helps remove transient bacteria by working with soap to create the

lather that reduces surface tension. Time is of essence but friction is the most essentialaspect of handwashing.

53. In handwashing by medical asepsis, Hands are held .

A. Above the elbow, The hands must always be above the waistB. Above the elbow, The hands are cleaner than the elbowC. Below the elbow, Medical asepsis do not require hands to be above the waistD. Below the elbow, Hands are dirtier than the lower arms


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* Hands are held BELOW the elbow in medical asepsis in contrast with surgical asepsis,

wherein, nurses are required to keep the hands above the waist. The rationale isbecause in medical asepsis, Hands are considered dirtier than the elbow and therefore,to limit contamination of the lower arm, The hands should always be below the elbow.

54. The suggested time per hand on handwashing using the time method is

A. 5 to 10 seconds each handB. 10 to 15 seconds each handC. 15 to 30 seconds each handD. 30 to 60 seconds each hand

* Each hands requires atleast 15 to 30 seconds of handwashing to effectively removetransient microorganisms.

55. The minimum time in washing each hand should never be below

A. 5 seconds

B. 10 secondsC. 15 secondsD. 30 seconds

* According to Kozier, The minimum time required for watching each hands is 10seconds and should not be lower than that. The recommended time, again, is 15 to 30seconds.

56. How many ml of liquid soap is recommended for handwashing procedure?

A. 1-2 mlB. 2-3 mlC. 2-4 ml

D. 5-10 ml

* If a liquid soap is to be used, 1 tsp [ 5ml ] of liquid soap is recommended forhandwashing procedure.

57. Which of the following is not true about sterilization, cleaning and disinfection?

A. Equipment with small lumen are easier to cleanB. Sterilization is the complete destruction of all viable microorganism including sporesC. Some organism are easily destroyed, while other, with coagulated protein requireslonger timeD. The number of organism is directly proportional to the length of time required forsterilization


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* Equipments with LARGE LUMEN are easier to clean than those with small lumen. B C

and D are all correct.

58. Karlita asked you, How long should she boil her glass baby bottle in water? Youcorrectly answered her by saying

A. The minimum time for boiling articles is 5 minutesB. Boil the glass baby bottler and other articles for atleast 10 minutesC. For boiling to be effective, a minimum of 15 minutes is required D. It doesnt matter how long you boil the articles, as long as the water reached 100degree Celsius

* Boiling is the most common and least expensive method of sterilization used in home.For it to be effective, you should boil articles for atleast 15 minutes.

59. This type of disinfection is best done in sterilizing drugs, foods and other things that

are required to be sterilized before taken in by the human body

A. Boiling WaterB. Gas sterilization

C. Steam under pressureD. Radiation

* Imagine foods and drugs that are being sterilized by a boiling water, ethylene oxidegas and autoclave or steam under pressure, They will be inactivated by these methods.Ethylene oxide gas used in gas sterlization is TOXIC to humans. Boiling the food will

alter its consistency and nutrients. Autoclaving the food is never performed. Radiationusing microwave oven or Ionizing radiation penetrates to foods and drugs thus,sterilizing them.

60. A TB patient was discharged in the hospital. A UV Lamp was placed in the roomwhere he stayed for a week. What type of disinfection is this?

A. Concurrent disinfectionB. Terminal disinfectionC. Regular disinfectionD. Routine disinfection

* Terminal disinfection refers to practices to remove pathogens that stayed in the

belongings or immediate environemnt of an infected client who has been discharged. Anexample would be Killing airborne TB Bacilli using UV Light. Concurrent disinfectionrefers to ongoing efforts implented during the client's stay to remove or limit pathogensin his supplies, belongings, immediate environment in order to control the spread of thedisease. An example is cleaning the bedside commode of a client with radium implant onher cervix with a bleach disinfectant after each voiding.

61. Which of the following is not true in implementing medical asepsis


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A. Wash hand before and after patient contactB. Keep soiled linens from touching the clothingsC. Shake the linens to remove dustD. Practice good hygiene

* NEVER shake the linens. Once soiled, fold it inwards clean surface out. Shaking thelinen will further spread pathogens that has been harbored by the fabric.

62. Which of the following is true about autoclaving or steam under pressure?

A. All kinds of microorganism and their spores are destroyed by autoclave machineB. The autoclaved instruments can be used for 1 month considering the bags are stillintactC. The instruments are put into unlocked position, on their hinge, during theautoclave

D. Autoclaving different kinds of metals at one time is advisable

* Only C is correct. Metals with locks, like clamps and scissors should be UNLOCKED inorder to minimize stiffening caused by autoclave to the hinges of these metals. NOT ALLmicroorganism are destroyed by autoclaving. There are recently discoveredmicroorganism that is invulnarable to extreme heat. Autoclaved instruments are to beused within 2 weeks. Only the same type of metals should be autoclaved as this willalteration in plating of these metals.

63. Which of the following is true about masks?

A. Mask should only cover the nose

B. Mask functions better if they are wet with alcoholC. Masks can provide durable protection even when worn for a long time and after eachand every patient care

D. N95 Mask or particulate masks can filter organism as mall as 1micromillimeter

* only D is correct. Mask should cover both nose and mouth. Masks will not functionoptimally when wet. Masks should be worn not greater than 4 hours, as it will loseeffectiveness after 4 hours. N95 mask or particulate mask can filter organism as small

as 1 micromillimeter.

64. Where should you put a wet adult diaper?

A. Green trashcanB. Black trashcanC. Orange trashcanD. Yellow trashcan

* Infectious waste like blood and blood products, wet diapers and dressings are thrown


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in yellow trashcans.

65. Needles, scalpels, broken glass and lancets are considered as injurious wastes. As anurse, it is correct to put them at disposal via a/an

A. Puncture proof containerB. Reused PET BottlesC. Black trashcanD. Yellow trashcan with a tag INJURIOUS WASTES

* Needles, scalpels and other sharps are to be disposed in a puncture proof container.

66. Miranda Priestly, An executive of RAMP magazine, was diagnosed with cancer of thecervix. You noticed that the radioactive internal implant protrudes to her vagina wheresupposedly, it should be in her cervix. What should be your initial action?

A. Using a long forceps, Push it back towards the cervix then call the physicianB. Wear gloves, remove it gently and place it on a lead container

C. Using a long forceps, Remove it and place it on a lead containerD. Call the physician, You are not allowed to touch, re insert or remove it

* A dislodged radioactive cervical implant in brachytherapy are to be picked by a LONGFORCEP and stored in a LEAD CONTAINER in order to prevent damage on the client'snormal tissue. Calling the physician is the second most appropriate action among thechoices. A nurse should never attempt to put it back nor, touch it with her bare hands.

67. After leech therapy, Where should you put the leeches?

A. In specially marked BIO HAZARD ContainersB. Yellow trashcanC. Black trashcan

D. Leeches are brought back to the culture room, they are not thrown away for they arereusable

* Leeches, in leech therapy or LEECH PHLEBOTOMY are to be disposed on a BIOHAZARD container. They are never re used as this could cause transfer of infection.These leeches are hospital grown and not the usual leeches found in swamps.

68. Which of the following should the nurse AVOID doing in preventing spread ofinfection?

A. Recapping the needle before disposal to prevent injuriesB. Never pointing a needle towards a body partC. Using only Standard precaution to AIDS PatientsD. Do not give fresh and uncooked fruits and vegetables to Mr. Gatchie, withNeutropenia


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* Never recap needles. They are directly disposed in a puncture proof container after

used. Recapping the needles could cause injury to the nurse and spread of infection. B Cand D are all appropriate. Standard precaution is sufficient for an HIV patient. A clientwith neutropenia are not given fresh and uncooked fruits and vegetables for even thenon infective organisms found in these foods could cause severe infection on animmunocompromised patients.

69. Where should you put Mr. Alejar, with Category II TB?

A. In a room with positive air pressure and atleast 3 air exchanges an hourB. In a room with positive air pressure and atleast 6 air exchanges an hour

C. In a room with negative air pressure and atleast 3 air exchanges an hourD. In a room with negative air pressure and atleast 6 air exchanges an hour

* TB patients should have a private room with negative air pressure and atleast 6 to 12air exhanges per hour. Negative pressure room will prevent air inside the room from

escaping. Air exchanges are necessary since the client's room do not allow air to get outof the room.

70. A client has been diagnosed with RUBELLA. What precaution is used for this patient?

A. Standard precautionB. Airborne precautionC. Droplet precautionD. Contact precaution

* Droplet precaution is sufficient on client's with RUBELLA or german measles.

71. A client has been diagnosed with MEASLES. What precaution is used for this patient?

A. Standard precaution

B. Airborne precautionC. Droplet precautionD. Contact precaution

* Measles is highly communicable and more contagious than Rubella, It requiresairborne precaution as it is spread by small particle droplets that remains suspended in

air and disperesed by air movements.

72. A client has been diagnosed with IMPETIGO. What precaution is used for thispatient?

A. Standard precautionB. Airborne precautionC. Droplet precautionD. Contact precaution


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* Impetigo causes blisters or sores in the skin. It is generally caused by GABS or Staph

Aureaus. It is spread by skin to skin contact or by scratching the lesions and touchinganother person's skin.

73. The nurse is to insert an NG Tube when suddenly, she accidentally dip the end of thetube in the clients glass containing distilled drinking water which is definitely not sterile.As a nurse, what should you do?

A. Dont mind the incident, continue to insert the NG TubeB. Obtain a new NG Tube for the clientC. Disinfect the NG Tube before reinserting it again

D. Ask your senior nurse what to do

* The digestive tract is not sterile, and therefore, simple errors like this would not causeharm to the patient. NGT tube need not be sterile, and so is colostomy and rectal tubes.Clean technique is sufficient during NGT and colostomy care.

74. All of the following are principle of SURGICAL ASEPSIS except

A. Microorganism travels to moist surfaces faster than with dry surfacesB. When in doubt about the sterility of an object, consider it not sterileC. Once the skin has been sterilized, considered it sterileD. If you can reach the object by overreaching, just move around the sterile field to pickit rather than reaching for it

* Human skin is impossible to be sterilized. It contains normal flora of microorganism. AB and D are all correct.

75. Which of the following is true in SURGICAL ASEPSIS?

A. Autoclaved linens and gowns are considered sterile for about 4 months as long as the

bagging is intactB. Surgical technique is a sole effort of each nurseC. Sterile conscience, is the best method to enhance sterile techniqueD. If a scrubbed person leaves the area of the sterile field, He/she must do handwashingand gloving again, but the gown need not be changed.

* Sterile conscience, or the moral imperative of a nurse to be honest in practicing steriletechnique, is the best method to enhance sterile technique. Autoclaved linens areconsidered sterile only within 2 weeks even if the bagging is intact. Surgical technique isa team effort of each nurse. If a scrubbed person leave the sterile field and area, hemust do the process all over again.

76. In putting sterile gloves, Which should be gloved first?

A. The dominant handB. The non dominant hand


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C. The left hand

D. No specific order, Its up to the nurse for her own convenience

* Gloves are put on the non dominant hands first and then, the dominant hand. Therationale is simply because humans tend to use the dominant hand first before the nondominant hand. Out of 10 humans that will put on their sterile gloves, 8 of them will putthe gloves on their non dominant hands first.

77. As the scrubbed nurse, when should you apply the goggles, shoe cap and mask priorto the operation?

A. Immediately after entering the sterile fieldB. After surgical hand scrubC. Before surgical hand scrubD. Before entering the sterile field

* The nurse should put his goggles, cap and mask prior to washing the hands. If hewash his hands prior to putting all these equipments, he must wash his hands again as

these equipments are said to be UNSTERILE.

78. Which of the following should the nurse do when applying gloves prior to a surgicalprocedure?

A. Slipping gloved hand with all fingers when picking up the second gloveB. Grasping the first glove by inserting four fingers, with thumbs up underneath the cuffC. Putting the gloves into the dominant hand firstD. Adjust only the fitting of the gloves after both gloves are on

* The nurse should only adjust fitting of the gloves when they are both on the hands.Not doing so will break the sterile technique. Only 4 gingers are slipped when picking upthe second gloves. You cannot slip all of your fingers as the cuff is limited and the thumb

would not be able to enter the cuff. The first glove is grasp by simply picking it up withthe first 2 fingers and a thumb in a pinching motion. Gloves are put on the nondominant hands first.

79. Which gloves should you remove first?

A. The glove of the non dominant handB. The glove of the dominant handC. The glove of the left handD. Order in removing the gloves Is unnecessary

* Gloves are worn in the non dominant hand first, and is removed also from the nondominant hand first. Rationale is simply because in 10 people removing gloves, 8 ofthem will use the dominant hand first and remove the gloves of the non dominant hand.

80. Before a surgical procedure, Give the sequence on applying the protective items


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listed below

1. Eye wear or goggles2. Cap3. Mask4. Gloves5. Gown

A. 3,2,1,5,4B. 3,2,1,4,5C. 2,3,1,5,4

D. 2,3,1,4,5

* The nurse should use CaMEy Hand and Body Lotion in moisturizing his hand beforesurgical procedure and after handwashing. Ca stands for CAP, M stands for MASK, Eystands for eye goggles. The nurse will do handwashing and then [HAND], Don the

gloves first and wear the Gown [BODY]. I created this mnemonic and I advise you use itbecause you can never forget Camey hand and body lotion. [ Yes, I know it is spelled as

CAMAY ]]

81. In removing protective devices, which should be the exact sequence?

1. Eye wear or goggles2. Cap3. Mask4. Gloves5. Gown

A. 4,3,5,1,2B. 2,3,1,5,4C. 5,4,3,2,1

D. 1,2,3,4,5

* When the nurse is about to remove his protective devices, The nurse will remove theGLOVES first followed by the MASK and GOWN then, other devices like cap, shoe cover,etc. This is to prevent contamination of hair, neck and face area.

82. In pouring a plain NSS into a receptacle located in a sterile field, how high shouldthe nurse hold the bottle above the receptacle?

A. 1 inchB. 3 inchesC. 6 inchesD. 10 inches

* Even if you do not know the answer to this question, you can answer it correctly byimagining. If you pour the NSS into a receptacle 1 to 3 inch above it, Chances are, The


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mouth of the NSS bottle would dip into the receptacle as you fill it, making it

contaminated. If you pour the NSS bottle into a receptacle 10 inches above it, that is toohigh, chances are, as you pour the NSS, most will spill out because the force will be toomuch for the buoyant force to handle. It will also be difficult to pour something preciselyinto a receptacle as the height increases between the receptacle and the bottle. 6 inchesis the correct answer. It is not to low nor too high.

83. The tip of the sterile forceps is considered sterile. It is used to manipulate theobjects in the sterile field using the non sterile hands. How should the nurse hold asterile forceps?

A. The tip should always be lower than the handleB. The tip should always be above the handleC. The handle and the tip should be at the same levelD. The handle should point downward and the tip, always upward

* A sterile forcep is usually dipped into a disinfectant or germicidal solution. Imagine, ifthe tip is HIGHER than the handle, the solution will go into the handle and into your

hands and as you use the forcep, you will eventually lower its tip making the solution inyour hand go BACK into the tip thus contaminating the sterile area of the forcep. Toprevent this, the tip should always be lower than the handle. In situation questions likethis, IMAGINATION is very important.

84. The nurse enters the room of the client on airborne precaution due to tuberculosis.Which of the following are appropriate actions by the nurse?

1. She wears mask, covering the nose and mouth2. She washes her hands before and after removing gloves, after suctioning the clients

secretion3. She removes gloves and hands before leaving the clients room4. She discards contaminated suction catheter tip in trashcan found in the clients room

A. 1,2B. 1,2,3C. 1,2,3,4D. 1,3

* All soiled equipments use in an infectious client are disposed INSIDE the client's roomto prevent contamination outside the client's room. The nurse is correct in using Maskthe covers both nose and mouth. Hands are washed before and after removing thegloves and before and after you enter the client's room. Gloves and contaminatedsuction tip are thrown in trashcan found in the clients room.

85. When performing surgical hand scrub, which of the following nursing action isrequired to prevent contamination?

1. Keep fingernail short, clean and with nail polish


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2. Open faucet with knee or foot control

3. Keep hands above the elbow when washing and rinsing4. Wear cap, mask, shoe cover after you scrubbed

A. 1,2B. 2,3C. 1,2,3D. 2,3,4

* Cap, mask and shoe cover are worn BEFORE scrubbing.

86. When removing gloves, which of the following is an inappropriate nursing action?

A. Wash gloved hand firstB. Peel off gloves inside outC. Use glove to glove skin to skin technique

D. Remove mask and gown before removing gloves

* Gloves are the dirtiest protective item nurses are wearing and therefore, the first to beremoved to prevent spread of microorganism as you remove the mask and gown.

87. Which of the following is TRUE in the concept of stress?

A. Stress is not always present in diseases and illnessesB. Stress are only psychological and manifests psychological symptomsC. All stressors evoke common adaptive responseD. Hemostasis refers to the dynamic state of equilibrium

* All stressors evoke common adaptive response. A psychologic fear like nightmare anda real fear or real perceive threat evokes common manifestation like tachycardia,tachypnea, sweating, increase muscle tension etc. ALL diseases and illness causes

stress. Stress can be both REAL or IMAGINARY. Hemostasis refers to the ARREST ofblood flowing abnormally through a damage vessel. Homeostasis is the one that refersto dynamic state of equilibrium according to Walter Cannon.

88. According to this theorist, in his modern stress theory, Stress is the non specificresponse of the body to any demand made upon it.

A. Hans SelyeB. Walter CannonC. Claude BernardD. Martha Rogers

* Hans Selye is the only theorist who proposed an intriguing theory about stress thathas been widely used and accepted by professionals today. He conceptualized two typesof human response to stress, The GAS or general adaptation syndrome which ischaracterized by stages of ALARM, RESISTANCE and EXHAUSTION. The Local adaptation


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syndrome controls stress through a particular body part. Example is when you have

been wounded in your finger, it will produce PAIN to let you know that you shouldprotect that particular damaged area, it will also produce inflammation to limit andcontrol the spread of injury and facilitate healing process. Another example is when youare frequently lifting heavy objects, eventually, you arm, back and leg muscleshypertorphies to adapt to the stress of heavy lifting.

89. Which of the following is NOT TRUE with regards to the concept of Modern StressTheory?

A. Stress is not a nervous energy

B. Man, whenever he encounters stresses, always adapts to itC. Stress is not always something to be avoidedD. Stress does not always lead to distress

* Man, do not always adapt to stress. Sometimes, stress can lead to exhaustion and

eventually, death. A,C and D are all correct.

90. Which of the following is TRUE with regards to the concept of Modern Stress Theory?

A. Stress is essentialB. Man does not encounter stress if he is asleepC. A single stress can cause a diseaseD. Stress always leads to distress

* Stress is ESSENTIAL. No man can live normally without stress. It is essential becauseit is evoked by the body's normal pattern of response and leads to a favorable adaptivemechanism that are utilized in the future when more stressors are encountered by the

body. Man can encounter stress even while asleep, example is nightmare. Disease aremultifactorial, No diseases are caused by a single stressors. Stress are sometimesfavorable and are not always a cause for distress. An example of favorable stress is

when a carpenter meets the demand and stress of everyday work. He then developscalluses on the hand to lessen the pressure of the hammer against the tissues of hishand. He also develop larger muscle and more dense bones in the arm, thus, a stresswill lead to adaptations to decrease that particular stress.

91. Which of the following is TRUE in the stage of alarm of general adaptation

syndrome?

A. Results from the prolonged exposure to stressB. Levels or resistance is increasedC. Characterized by adaptationD. Death can ensue

* Death can ensue as early as the stage of alarm. Exhaustion results to a prolongedexposure to stress. Resistance is when the levels of resistance increases andcharacterized by being able to adapt.


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92. The stage of GAS where the adaptation mechanism begins

A. Stage of AlarmB. Stage of ResistanceC. Stage of HomeostasisD. Stage of Exhaustion

* Adaptation mechanisms begin in the stage of alarm. This is when the adaptivemechanism are mobilized. When someone shouts SUNOG!!! your heart will begin to beatfaster, you vessels constricted and bp increased.

93. Stage of GAS Characterized by adaptation

A. Stage of AlarmB. Stage of Resistance

C. Stage of HomeostasisD. Stage of Exhaustion

94. Stage of GAS wherein, the Level of resistance are decreased


* Resistance are decreased in the stage of alarm. Resistance is absent in the stage ofexhaustion. Resistance is increased in the stage of resistance.

95. Where in stages of GAS does a person moves back into HOMEOSTASIS?


96. Stage of GAS that results from prolonged exposure to stress. Here, death will ensue

unless extra adaptive mechanisms are utilized


97. All but one is a characteristic of adaptive response

A. This is an attempt to maintain homeostasis


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B. There is a totality of response

C. Adaptive response is immediately mobilized, doesnt require timeD. Response varies from person to person

* Aside from having limits that leads to exhaustion. Adaptive response requires time forit to act. It requires energy, physical and psychological taxes that needs time for ourbody to mobilize and utilize.

98. Andy, a newly hired nurse, starts to learn the new technology and electronic devicesat the hospital. Which of the following mode of adaptation is Andy experiencing?

A. Biologic/Physiologic adaptive modeB. Psychologic adaptive modeC. Sociocultural adaptive modeD. Technological adaptive mode

99. Andy is not yet fluent in French, but he works in Quebec where majority speaksFrench. He is starting to learn the language of the people. What type of adaptation is

Andy experiencing?


* Sociocultural adaptive modes include language, communication, dressing, acting andsocializing in line with the social and cultural standard of the people around the adaptingindividual.

100. Andy made an error and his senior nurse issued a written warning. Andy arrived inhis house mad and kicked the door hard to shut it off. What adaptation mode is this?


* Andy uses a defense mechanism called DISPLACEMENT. All DMs are categorized asPSYCHOLOGIC ADAPTIVE RESPONSE to stressors.

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